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See a sample rate comparisonCPT 21899 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Unlisted Procedure Neck Or Th, Unlisted Procedure Neck Or Thorax
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21899 |
| Medicaid Fee Schedule | View Medicaid rates for 21899 |
National average reimbursement for CPT 21899 by major payers:
$1,405.55
$156.57
$1,910.65
$1,081.62
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CPT 21899
5 of 25 sample ratesHigher to lower in this preview
Summit Medical Group PA, Summit Medical Group Ambulatory Surgery Center
Summit Medical Group, P.A.
$2,281.00Published rateDigestivecare, LLC, Digestivecare Endoscopy Unit
Digestive Care, Inc.
$574.00Published ratePacific Northwest Urology Specialists, PLLC, Pacific Northwest Urology Surgery Center
Pacific Northwest Urology Specialist, PLLC
$300.00Published rateSurgcenter Of Pine Ridge LLC
$132.00Published rateEdgeworth Commons Group LLC, Surgery Center At Edgworth Commons
Edgeworth Commons Group LLC
$50.00Published rate
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See a sample payer proposalCPT 21899 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21899 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 21899 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 21899-CPT | High | Unlisted Procedure Neck Or Th, Unlisted Procedure Neck Or Thorax |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21899. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21899 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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